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[胸段食管义齿嵌顿:手术治疗——一例报告]

[Denture impaction in the thoracic esophagus: surgical treatment - a case report].

作者信息

Alexandrino Henrique, Fernandes Miguel, Ferreira Luis, Tralhão J Guilherme, Castro E Sousa Francisco

机构信息

Serviço de Cirurgia A dos Hospitais da Universidade de Coimbra, Centro Hospitalar e Universitário de Coimbra - Clínica Universitária de Cirurgia 3 da Faculdade de Medicina da Universidade de Coimbra, Portugal.

出版信息

Rev Port Cir Cardiotorac Vasc. 2012 Jan-Mar;19(1):27-9.

Abstract

Esophageal foreign body impaction is mostly managed with endoscopic retrieval. However, in cases of large or irregularly shaped foreign bodies, or in cases of long standing impaction, this technique carries a high risk of perforation and a surgical approach is often mandatory.The authors report the case of a 55 year old woman, with a past history of mental retardation, presenting with dysphagia for solid food and regurgitation beginning one month earlier. After failed extraction by flexible esophagoscopy,the denture was removed by esophagotomy through a postero-lateral thoracotomy. In the postoperative period the patient developed a leakage of the suture line with resultant esophago-pleural fistula which was managed with double esophageal exclusion. She was discharged on the 40th postoperative day on semi-solid diet and is presently (eight months after the first surgery) symptom free.

摘要

食管异物嵌顿大多通过内镜取出进行处理。然而,对于大型或形状不规则的异物,或长期嵌顿的情况,这种技术存在较高的穿孔风险,手术方法往往是必要的。作者报告了一例55岁女性病例,该患者有智力发育迟缓病史,一个月前开始出现固体食物吞咽困难和反流症状。经柔性食管镜取物失败后,通过后外侧开胸食管切开术取出假牙。术后患者出现缝线处渗漏,导致食管胸膜瘘,通过双重食管闭锁进行处理。术后第40天,患者出院,进食半固体食物,目前(首次手术后八个月)无症状。

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